Stent delivery under direct visualization

1. A tissue manipulation system, comprising:

a reconfigurable hood structure with a distal end, the hood structure being asymmetric and having a low profile delivery configuration and an expanded deployed configuration which defines an open area bounded at least in part by the hood structure and by an interface surface extending across the distal end of the hood structure, the interface surface configured to engage against a tissue region, wherein the open area is in fluid communication with an environment external to the hood structure;

a catheter in communication with the open area such that introduction of a fluid through the catheter purges the open area of bodily fluid, wherein the catheter extends along a longitudinal axis and wherein the interface surface is slanted relative to the longitudinal axis when the hood structure is fully expanded in the expanded deployed configuration; and

an imaging element positioned on the hood structure such that the open area is visualized through the fluid by the imaging element.

2. The system of claim 1 wherein the catheter includes a steerable segment proximal to the hood structure.

3. The system of claim 2 wherein the steerable segment includes pivotally connected links.

4. The system of claim 1 wherein the catheter includes a passively pre-shaped bend proximal to the hood structure.

5. The system of claim 1 further comprising a scaffold structure supporting the reconfigurable hood structure.

6. The system of claim 5 wherein one arm of the scaffold structure has a different length from a second arm of the scaffold structure.

7. The system of claim 5 wherein the imaging element is coupled to the scaffold structure.

8. A tissue manipulation system comprising:

a reconfigurable hood structure with a distal end, the hood structure having a low profile delivery configuration and an expanded deployed configuration which defines an open area bounded at least in part by the structure and by an interface surface extending across the distal end of the hood structure, the open area in fluid communication with an environment external to the hood structure;

a catheter in communication with the open area such that introduction of a fluid through the catheter purges the open area of bodily fluid, wherein the catheter extends along a longitudinal axis and wherein the interface surface is slanted relative to the longitudinal axis when the hood structure is in the expanded deployed configuration; and

an imaging element positioned on the hood structure such that the open area is visualized through the fluid by the imaging element,

wherein an aperture is defined through the interface surface and the aperture is non-perpendicular to the longitudinal axis of the catheter.

9. The system of claim 8 wherein the aperture has an aperture diameter smaller than an outer lip diameter of the hood structure in the expanded deployed configuration.

10. A tissue manipulation system, comprising:

a reconfigurable hood structure with a distal end, wherein the hood structure is asymmetric, the hood structure having a low profile delivery configuration and an expanded deployed configuration which defines an open area bounded at least in part by the structure and by an interface surface extending across the distal end of the hood structure, the open area in fluid communication with an environment external to the hood structure;

a catheter in communication with the open area such that introduction of a fluid through the catheter purges the open area of bodily fluid, wherein the catheter extends along a longitudinal axis and wherein the interface surface is slanted relative to the longitudinal axis when the hood structure is in the expanded deployed configuration; and

an imaging element positioned on the hood structure such that the open area is visualized through the fluid by the imaging element.